Deer presence rather than abundance determines the population density of the sheep tick, Ixodes ricinus, in Dutch forests

Background Understanding which factors drive population densities of disease vectors is an important step in assessing disease risk. We tested the hypothesis that the density of ticks from the Ixodes ricinus complex, which are important vectors for tick-borne diseases, is determined by the density of deer, as adults of these ticks mainly feed on deer. Methods We performed a cross-sectional study to investigate I. ricinus density across 20 forest plots in the Netherlands that ranged widely in deer availability to ticks, and performed a deer-exclosure experiment in four pairs of 1 ha forest plots in a separate site. Results Ixodes ricinus from all stages were more abundant in plots with deer (n = 17) than in plots without deer (n = 3). Where deer were present, the density of ticks did not increase with the abundance of deer. Experimental exclosure of deer reduced nymph density by 66% and adult density by 32% within a timeframe of two years. Conclusions In this study, deer presence rather than abundance explained the density of I. ricinus. This is in contrast to previous studies and might be related to the relatively high host-species richness in Dutch forests. This means that reduction of the risk of acquiring a tick bite would require the complete elimination of deer in species rich forests. The fact that small exclosures (< 1 ha) substantially reduced I. ricinus densities suggests that fencing can be used to reduce tick-borne disease risk in areas with high recreational pressure

Few vertebrate species dominate the Borrelia burgdorferi s.l. Life cycle

Background. In the northern hemisphere, ticks of the Ixodidae family are vectors of diseases such as Lyme borreliosis, Rocky Mountain spotted fever and tick-borne encephalitis. Most of these ticks are generalists and have a three-host life cycle for which they are dependent on three different hosts for their blood meal. Finding out which host species contribute most in maintaining ticks and the pathogens they transmit, is imperative in understanding the drivers behind the dynamics of a disease. Methods. We performed a systematic review to identify the most important vertebrate host species for Ixodes ricinus and Borrelia burgdorferi s.l. as a well-studied model system for tick-borne diseases. We analyzed data from 66 publications and quantified the relative contribution for 15 host species. Review results. We found a positive correlation between host body mass and tick burdens for the different stages of I. ricinus. We show that nymphal burdens of host species are positively correlated with infection prevalence with B. burgdorferi s.l., which is again positively correlated with the realized reservoir competence of a host species for B. burgdorferi s.l. Our quantification method suggests that only a few host species, which are amongst the most widespread species in the environment (rodents, thrushes and deer), feed the majority of I. ricinus individuals and that rodents infect the majority of I. ricinus larvae with B. burgdorferi s.l. Discussion. We argue that small mammal-transmitted Borrelia spp. are maintained due to the high density of their reservoir hosts, while bird-transmitted Borrelia spp. are maintained due to the high infection prevalence of their reservoir hosts. Our findings suggest that Ixodes ricinus and Borrelia burgdorferi s.l. populations are maintained by a few widespread host species. The increase in distribution and abundance of these species, could be the cause for the increase in Lyme borreliosis incidence in Europe in recent decades

Frequency and outcome of re-interventions after endovascular repair for abdominal aortic aneurysm: A prospective cohort study:A prospective cohort study

AbstractPurpose. To describe frequency, type, and outcome of re-intervention after endovascular aortic aneurysm repair (EVAR).Methods. Between September 1996 and December 2003, 308 patients were treated, with data collected prospectively. No patient was lost to follow up, but two were excluded (one primary conversion, and one post-operative death). Vanguard, Talent, Excluder, Zenith, and Quantum devices were used. Follow up required a CT scan before discharge. Initially, a CT scan was done at each follow up. Subsequently, we used duplex ultrasound and abdominal X-ray, with CT scan used selectively.Results. Mean follow-up was 36±22 months. Re-interventions were required in 47 (15%) patients, 31 (66%) elective and 16 (34%) emergency cases. In 32 patients, the primary re-intervention was successful; in 15 patients an additional 13 secondary and four tertiary re-interventions were required. A total of 72 adjunctive manoeuvres were performed: 49 endovascular (68%) and 23 open (32%). The success of endovascular re-interventions was 80%. The success of open re-interventions was 96%. Open conversions were required in nine patients (3%). There was no mortality.Conclusion. EVAR was associated with a low burden of re-interventions, with only 15% patients requiring re-intervention. Our long-term follow up, without regular CT, was simple and effective